Analysis Of Related Factors Of Lymph Node Metastasis In Left Colon Cancer

Objective:In this study,the clinical risk factors of the lymph node transfer of the left colon cancer through collecting and analyzing the clinical data,in order to enrich our knowledge of clinical left colon cancer lymph node metastasis and provide a theoretical basis for the clinical treatment and prognosis.Methods:1.The sample into the standard and the exclusion criteria were set.2.The patients who are in line with the established standard were collected and their related clinical factors were recorded(e.g.serum CEA level,tumor differentiation degree,gross tumor type,vascular tumor thrombus and depth of tumor invasion(T staging)).3.The clinical factors associated with lymph node metastasis in left colon cancer were analyzed by single factor analysis of variance.4.The multiple factor Logistic regression analysis was used to determine the independent risk factors affecting lymph node metastasis in left colon cancer.Results:1.Gender and lymph node metastasis in the left-sided colon cancer:The lymph node metastasis rate was 38.4%in males and 42.3%in females.The difference between the two groups of transfer rates was not statistically significant(P=0.732>0.05).2.The correlation between age and lymph node metastasis of left colon cancer:Lymph node metastasis rate was 42.7%in patients aged 60 years or younger,and lymph node metastasis rate was 37.1%in patients>60 years old.The difference between the two groups of transfer rates was not statistically significant(P=0.523>0.05).3.The correlation between preoperative CEA levels and lymph node metastasis in left colon cancer:The lymph node metastasis rate was 34.4%in patients with preoperative CEA levels ≤ 10 ng/ml,and the lymph node metastasis rate was 54.8%in patients with preoperative CEA levels>10 ng/ml.The difference between the two groups of transfer rates was statistically significant(P=0.028<0.05).4.The correlation between preoperative CA19-9 and lymph node metastasis in left colon cancer:The lymph node metastasis rate was 38.1%in patients with preoperative CA19-9 ≤ 39U/ml,and the lymph node metastasis rate was 48.0 in patients with CA19-9>39U/ml preoperatively.%.The difference between the two groups of transfer rates was not statistically significant(P=0.38>0.05).5.The correlation between the maximum diameter of the tumor and lymph node metastasis in the left part of the colon cancer:the lymph node metastasis rate was 42.0%in the patients with the maximum diameter ≤ 5cm,and the lymph node metastasis rate was 34.6%in the patients with the maximal diameter>5cm.The difference between the two groups of transfer rates was not statistically significant(P=0.396>0.05).6.Correlation of gross tumor type and left lymph node metastasis of left colon cancer:The lymph node metastasis rate was 43.4%in ulcer type + infiltrating type,and 21.4%in uplift type.The difference between the two groups of transfer rates was statistically significant(P=0.035<0.05).The correlation between depth of bowel infiltration and lymph node metastasis of left colon cancer:lymph node metastasis rate was 11.1%in T1+T2 patients,and 43.2%in T3+T4 patients.The difference between the two groups was statistically significant(P>0.05).P=0.01<0.05).8.The correlation between the degree of differentiation and lymph node metastasis of left colon cancer:Lymph node metastasis rate was 33.6%in moderately differentiated + well-differentiated patients,and 50.1%in poorly differentiated patients.The difference between the two groups of transfer rates was statistically significant(P=0.028<0.05).9.The correlation between vascular tumor embolus and lymph node metastasis of left colon cancer:The lymph node metastasis rate was 100.0%in patients with vascular cancer embolus and 37.7%in patients without vascular cancer embolus.The difference between the two groups was statistically significant(P=0.009<0.05).10.Correlation of diabetes mellitus and lymph node metastasis of left colon cancer:The lymph node metastasis rate was 31.3%in patients with diabetes,and the lymph node metastasis rate was 45.0%in patients without diabetes.There was no significant difference between the two groups in metastasis rate(P= 0.102>0.05).Conclusion:1.Preoperative serum CEA level,tumor differentiation degree,gross tumor type,vascular tumor thrombus and depth of tumor invasion(T stage)were correlated with lymph node metastasis of left colon cancer.2.The level of preoperative serum CEA and the degree of tumor differentiation are independent risk factors for lymph node metastasis in left colon cancer.